Reye's syndrome commonly affects children recovering from a viral infection. Read about its causes, symptoms, pathophysiology, diagnosis, and treatment.
Reye's or Reye syndrome is a severe condition that usually results in liver and brain swelling but can affect any organ in the body. It is a rare condition that commonly affects children recovering from a viral infection, such as the flu. The use of Aspirin is believed to be the cause, so avoid giving Aspirin to children or teenagers for fever or headache. If your child develops confusion, loss of consciousness, or seizures, get to the emergency room immediately. The child’s life can be saved by diagnosing and treating this condition early.
An Australian pathologist R. Douglas Reye was the first person to describe this syndrome in 1963, hence the name Reye’s syndrome. The use of Aspirin is approved for children above 3 years old, but do not give it to children and teenagers when they are recovering from a viral infection. In case your child has fever or pain, Paracetamol (Acetaminophen) or Ibuprofen are safer options. Always consult your child’s pediatrician before giving him or her any medicine.
The cause of Reye's syndrome is still not clear. But, researchers have identified some factors that are linked to this syndrome. It was observed that children who were treated with Aspirin for fever and pain associated with viral infections, especially chickenpox and flu, developed this syndrome.
It was also noticed that children and teenagers with fatty acid oxidation disorders, which is a group of hereditary metabolic disorders where the enzyme required to break down fatty acids is either missing or not functioning properly, were also affected more when given Aspirin.
Many infectious diseases have been linked to Reye’s syndrome. The viruses that increase the risk of Reye’s syndrome are:
Influenza A and B.
HIV (human immunodeficiency virus).
Hepatitis A and B.
And infection caused by the following bacteria might also increase the risk:
This is an extremely rare condition, and the survival rate is around 80 %.
Mitochondrial injury is thought to be the cause. When the mitochondria (the powerhouse of a cell) gets damaged, it inhibits oxidative phosphorylation and fatty-acid beta-oxidation. This might lead to the accumulation of ammonia, which results in the levels of ammonia and acidity in the blood to rise. The child’s blood sugar level might also drop. It also causes the brain and liver to swell up. The liver of deceased children appears fatty and mitochondrial changes can be appreciated. The brain shows edema and other similar findings.
The salicylates present in Aspirin can damage the mitochondria, which gets intensified during a viral infection due to the release of endotoxins and cytokines, and leads to Reye’s syndrome. Some toxins and other medications are also said to increase the risk of this syndrome, which include:
Hypoglycin present in ackee fruit.
The signs and symptoms of this syndrome usually start around 3 to 5 days after the symptoms of viral infection begin.
The early signs and symptoms are:
Lethargy or sleepiness.
The more serious signs and symptoms include:
Weakness in hands and feet.
Loss of consciousness.
Parents should identify the signs and symptoms of Reye’s syndrome promptly and seek help immediately. If your child is recovering from a viral infection, such as cold, flu, or chickenpox, and if he or she exhibits the following symptoms, consult a doctor immediately:
The doctor will conduct a complete physical examination and perform tests to rule out other conditions that can cause similar symptoms. The tests include:
Blood and urine tests - to detect the build-up of toxins or bacteria in the blood and to check how well the liver is functioning. They might also check for inherited metabolic disorders.
CT of the Brain - to detect brain swelling.
Lumbar Puncture or Spinal Tap - cerebrospinal fluid (CSF) is collected by inserting a needle with a syringe into the lower spine. This fluid is then tested for bacterial or viral infection.
Liver Biopsy - a sample of the liver is checked for any liver disease.
Skin Biopsy - a sample of the skin is taken to diagnose fatty acid oxidation disorders and other metabolic disorders.
Reye’s disease is extremely rare, and other conditions that can result in similar symptoms include:
Inherited metabolic disorders.
Meningitis - the inflammation of the membranes covering the brain and spinal cord.
Encephalitis - brain inflammation.
Reye’s syndrome is a medical emergency, which needs prompt diagnosis and treatment. The child needs to be hospitalized. There is no specific treatment or cure for this condition, as the exact cause is not known. The child will be given supportive treatment that focuses on managing the symptoms and complications. The child might need:
Electrolytes and intravenous fluids to prevent dehydration and maintain electrolytes balance.
Insulin is administered to increase the metabolism of glucose.
Corticosteroids might be given to reduce brain swelling.
Diuretics to remove excess fluid.
Ammonia detoxicants to reduce the level of ammonia in the blood.
The child might be put on a ventilator if he or she has breathing problems.
Anticonvulsants are given to control seizures.
The doctor will closely monitor the liver and heart function. Late diagnosis of Reye’s syndrome can cause permanent brain damage and can also be fatal. Early diagnosis is crucial.
Even though Aspirin is approved to be used in children above 3 years of age, avoid giving it to children and teenagers for fever and pain. Also, avoid medicines that contain Aspirin in combination with other drugs.
Ask the doctor to screen your newborn baby for fatty acid oxidation disorders. If your child tests positive for this disorder, then never give them Aspirin.
Make sure you check the medicine label before asking your child to take any tablet. The other names for Aspirin are:
Instead of Aspirin, you can use Paracetamol (Acetaminophen) or Ibuprofen for fever and pain.
Note - Children with Kawasaki disease or other chronic diseases might need prolonged treatment with medicines that contain Aspirin. In case your child needs to take Aspirin, make sure his or her chickenpox and flu vaccine is up-to-date.
The survival rate is around 80 %. Prognosis is bad if the child is in a coma. In some cases, this syndrome can result in complications like:
Poor attention span.
Partial loss of vision.
Some degree of hearing loss.
For more information, consult a pediatrician online.
Reye's syndrome is a serious condition but a rare disorder that occurs in children and adolescents. It usually occurs in children recovering from a viral infection, resulting in swelling in the liver (hepatitis) and brain (encephalopathy).
Reye's syndrome affects many organs, but the most commonly affected organs are the liver and brain.
Reye's syndrome cannot go away on its own because there is no cure for it, but the symptoms can be managed. Steroids can be used to reduce swelling in the brain. Experts are not sure what causes this syndrome, but the more clear evidence is that it occurs in children taking Aspirin who are recovering from a viral infection.
Even though most of the children and teenagers with Reye's syndrome can survive, it can also cause permanent brain damage. Without proper diagnosis and treatment, Reye's can be fatal within a few days.
Reye's syndrome is a rare but severe condition that can cause liver and brain damage. Without proper treatment, it can be fatal within a few days.
Reye's syndrome is not a contagious disease, but it is often noticed in children recovering from viral infections like flu or chickenpox.
Reye's syndrome has become less common because most doctors and parents do not give Aspirin to children who are recovering from a viral infection. It is better to give Acetaminophen (Paracetamol) or Ibuprofen if there is any pain instead of Aspirin.
Reye's syndrome's most common liver-related complications are abnormal liver function, fatty deposits in the liver, and poor bleeding and clotting caused by liver failure.
Reye's syndrome was discovered by an Australian pathologist R. Douglas Reye in 1963. Therefore it is named Reye's syndrome.
The test used to diagnose Reye's syndrome are:
- Spinal tap (Lumbar puncture).
- Liver biopsy.
- Skin biopsy.
- CT (computed tomography) scan of the head.
- MRI (magnetic resonance imaging) scan of the head.
The standard treatment for Reye's syndrome usually involves hospitalization, but in severe cases, the doctor may send the children to the intensive care unit (ICU). The other treatment includes:
- Diuretics to treat increased fluid loss due to urination and intracranial pressure.
- Giving intravenous fluids like glucose and electrolytes.
- Doctors can provide medications like Vitamin K, plasma, and platelets to treat bleeding due to liver abnormalities.
- Cooling blankets can be used in patients to maintain internal body temperature.
Reye's syndrome can occur in people of any age group, but it is most commonly seen in children and teenagers who take Aspirin while recovering from a viral infection.
Last reviewed at:
27 Nov 2020 - 5 min read
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